Purtscher-Like Retinopathy Associated with Synthetic Cannabinoid (Bonzai) Use

Purtscher’s retinopathy is a microvascular occlusive disease initially described as retinal edema, cotton wool-like exudation, and hemorrhages occurring after severe head trauma. A similar clinical presentation called Purtscher-like retinopathy is associated with systemic diseases instead of trauma. In the present case, ophthalmic eksamination of a patient with complaints of blurred vision related to substance (Bonzai) use revealed bilateral cotton-wool spots. Purtscher-like retinopathy was diagnosed based on fluorescein angiography and optical coherence tomography findings. This is the first case of Purtscher-like retinopathy associated with Bonzai use described in the literature

Comparison of the Effectiveness of Topical and Oral Beta Blockers in the Treatment of Childhood Hemangiomas

Purpose: Hemangiomas are the most common vascular tumors in childhood, and the treatment options have undergone profound changes in recent years. In this study, we aimed to compare the efficacy and safety of beta-blockers on hemangiomas, both topi-cal and oral, with non-pharmacological treatment in the pediatric age group. Material and Methods: We retrospectively reviewed the medical records of pediatric patients with hemangiomas. Results: Fifty-three patients (F/M=40/13) were enrolled in this study. Superficial hemangiomas were detected in 14 (26.4%) patients, and deep hemangiomas were detected in 39 (73.6%) patients. Seventeen patients were followed without medication, 19 were treated with a topical beta blocker, and 17 were treated with an oral beta blocker. Twelve patients with superficial hemangi-omas were followed without medication, while two received topical timolol treatment. A comparison of lesion progression in patients with superficial hemangiomas in the non-pharmacological treatment and topical treatment groups showed that the mean scores of success, in terms of mean fading and reduction in lesion depth, were significantly higher at the first month (7.0 vs. 1.66; p=0.049; 6.0 vs. 1.5; p=0.045). Among patients with deep hemangiomas, a comparison of mean fading scores showed no difference between the oral and topical treatment groups in the first and fourth months (p=0.551, p=0.551). Conclusion: We believe that oral beta-blockers can be used instead of topical treatment in the future, and they will be preferred more by clinicians and families due to less side effects

Families Affairs: Fever

Ateş, çocuk acil servisine en sık başvuru nedenlerinden biridir. Aileler tarafından bir semptom olarak değil de bir hastalık olarak algılandığı için gereksiz endişelere yol açmaktadır. Ateşin ve ateşe yaklaşımın sağlık çalışanları, aileler ve çocuğun bakımını üstlenen kişilerce iyi bilinmesi gereklidir. Bu makalenin amacı ateş hakkında bilgi vererek, ateşli çocuğa nasıl yaklaşılması gerektiğini vurgulamaktırFever is one of the most common complaints that is admissions to the pediatric emergency services. onsulted to the pediatricians. It causes unnecessary anxiety because parents perceive fever as an illness, not as a symptom. Fever and fever management must be known well by the health care workers, parents and those responsible for child’s care. This article aims to provide information about fever and emphasize how to approach the febrile chil

Evaluation of the Clinical Findings of Pediatric Patients With Vesicoureteral Reflux to Assess Disease Severity: Vesicoureteral Reflux and Disease Severity

Background and Aim: This study aims to investigate how to benefit from clinical andlaboratory methods for further selection in the decision-making process to perform acystogram and assess the severity of vesicoureteral reflux (VUR).Methods: We retrospectively reviewed the voiding cystourethrography (VCUG), ultrasound(US), and medical records of pediatric patients with VUR. The exclusion criteria includedhaving neurological lesions, a posterior urethral valve, and a lack of documentation of a renalultrasound or voiding cystourethrography (VCUG). At the time of data entry, we retrieveddemographic findings and laboratory test results, including routine biochemical parameters,complete blood count, and calculated blood sodium/potassium ratioResults: Sixty-three pediatric patients with VUR were enrolled in this study. The mean (SD)age of the patients (female/male=37/26) at the time of diagnosis was 62.0±6.5 months (range1-195 months). Seventeen patients (26.9%) had high-grade VUR, and 46 patients (73.1%)had low-to-moderate-grade VUR. The mean potassium level of the mean serum sodium topotassium (Na/K) ratio was significantly lower in the high-grade VUR group (4.7±0.5 vs.4.3±0.4 mEq/L, P=0.022, 29±3 vs. 32±3, P=0.029, respectively). The proportion of patientswith severe anterior-posterior (AP) diameter dilation was significantly higher in the lowgradeVUR group than in the high-grade VUR group (4 [23.5%] vs. 35 [76.5%], P=0.005).Conclusion: We conclude that the low serum sodium to potassium (Na/K) ratio allows us topredict the VUR grade. The effect of VUR on the renin-angiotensin-aldosterone system canbe demonstrated by prospective controlled studies

Childhood urinary system stone diseases

son yıllarda çok daha fazla tanı almaya başlamıştır. Erken tanı, ortaya çıkabilecek ciddi morbiditeleri önlemek açısından önem taşır. Çocuklarda taş oluşumu altta yatan anatomik veya metabolik bir bozukluktan kaynaklanabilir. Klinik bulgular, çocuğun yaşı, taşın lokalizasyonu ve büyüklüğü ve altta yatan hastalığa bağlı olarak değişmektedir. Tedavide altta yatan nedenin ortadan kaldırılması önemlidir. Tedavi sonrasında yeni taş oluşumunun önlenmesi için yeterli sıvı alımının sağlanması, diyet ve yaşam tarzının düzenlenmesi gereklidirCurrently, the diagnosis of pediatric stone disease are increasing. Early diagnosis is essential to prevent possible serious morbidities. Pediatric stone disease can be related to an underlying anatomical or metabolic disorder. Clinical findings are variable and they differ related to the child’s age, localization of stone, size and underlying diseases. It is important to eliminate the underlying reason in the treatment of this condition. The clinician should warn families about inadequate fluid intake, dietary changes and lifestyle changes to prevent new stone formations after the initial treatmen

Meniere's Disease

Meniere hastalığı idiyopatik semptomatik endolenfatik hidrops olarak da bilinen, epizodik spontan vertigo atakları, fluktuasyon gösteren işitme kaybı, kulakta dolgunluk/basınç hissi ve tinnitus ile karakterize bir iç kulak hastalığıdır. Hastalığın başlama yaşları sıklıkla 50-60 yaşlarıdır. Hastalığın teşhisinde anamnez ve spesifik odyometrik testlerden yararlanılır. Kesin tanısının konulması ancak histopatolojik inceleme ile mümkün olduğundan günümüzde halen tanısı zor koyulan hastalıklar arasındadır. Tedavi hastaların büyük kısmında medikaldir ve hastalara psikolojik desteğin eklenmesi önerilir. Medikal tedaviye cevap vermeyen hastalarda cerrahi tedavi gündeme gelebilir. Bu derlemede Meniere hastalığının patogenezi, fizyolojisi, semptomatolojisi, tanı ve tedavi şekilleri ele alınacaktırMeniere’s disease, also known as idiopathic symptomatic endolymphatic hydrops, is an inner ear disease characterized by spontaneous vertigo attacks, fluctuating hearing loss, ear fullness/pressure sensation and tinnitus. Age of onset is often 50-60 years. History and specific audiometric investigations are used in the diagnosis. As definitive diagnosis is only possible with the histopathological examination, nowadays Meniere's disease is currently placed among the diseases whose diagnosis is difficult. In the majority of patients, treatment is medical and additional psychological support is recommended. Surgical treatment may be considered in patients who don’t respond to medical therapy. In this review, pathogenesis, physiology, symptomatology, diagnosis and treatment of Meniere’s disease will be discusse

Nutrition Support in Pediatric Patients with Malnutrition

WOS: 000498747600180

Insidious danger in childhood era's; subclinical hypothyroidism

Tiroid hormonları; santral sinir sistemi gelişimi, büyüme, gelişme, vücut ısısı regülasyonu, lipit, karbonhidrat ve enerji metabolizması, iskelet sistemi üzerinde önemli role sahiptir. Diğer yönden çocukluk çağında santral sinir sistemi myelinizasyonunda görevli olduğu için önemi farklıdır. Subklinik hipotiroidi, serum tiroid stimulan hormon seviyesinin orta düzeyde artması ile birlikte serum tiroid hormon seviyelerinin normal referans laboratuvar aralığında olmasıdır. Çocuklarda %2 oranında görülmektedir. Etiyolojisinin büyük bir kısmını otoimmün tiroidit ve iyot eksikliği oluşturmaktadır. Asemptomatik olguların zamanında tanımlanması ve tedavisi önemlidir. Olgularda guatr, büyüme-gelişme geriliği veya duraksaması, ders başarısında azalma, negativizm, depresyon, obezite, demir eksikliği anemisi, dislipidemi, kemik yaşı geriliğinde levotiroksin tedavisi başlanması uygundur.Thyroid hormones have an important role on the central nervous system, growth, development, body temperature regulation, metabolism of lipid, carbohydrate and energy, musculoskeletal system. The other hand, it has a different importance for its role in the myelinization of the central nervous system during the childhood period. Subclinical hypothyroidism (SH), is diagnosed when peripheral thyroid hormone levels are within normal reference laboratory range but serum thyroid-stimulating hormone levels are mildly elevated. Prevalance of subclinical hypothyroidism in chilhood is seen about %2. The majority of its etiology is due to the autoimmune thyroiditis and iodine deficiency. It is important to diagnose and treat the asymptomatic cases in a timely manner. Thyroxin treatment should be started if goiter, growth velocity is slowed down, decline in school success, negativism, depression, obesity, refractory iron deficiency anemia dyslipidemia, bone age retardation

Medical treatment of vertigo

Vertigo (baş dönmesi), sadece kulak burun boğaz değil, aile hekimliği pratiğinde de sık rastlanan bir hastalık grubunu oluşturmaktadır. Etyolojisinde çok çeşitli hastalıkların bulunduğu bu patolojinin kesin tanısı her zaman mümkün olamamaktadır. Tedavide öncelikli amaç, akut vertigo atağı ile gelen hastanın semptomlarının azaltılması olmalıdır. Vertigonun medikal tedavisinin anlatılacağı bu bölümde ülkemizdeki mevcut ilaçlar ve tedavi dozlarından da bahsedilecektirUVertigo (dizziness), constitutes a common group of diseases not only in the practice of otolaryngology, also in the practice of family physicians. There are various diseases in the etiology of this pathology and definitive diagnosis is not always possible. The primary objective in the treatment should be reduction of symptoms in the patients with acute attacks of vertigo. In this section, medical treatment of vertigo will be described with mentioning of the current medications and their therapeutic doses available dosage in our countr

Editöre Mektup

R. Comparison of Bruker Biotyper matrix-assisted laser desorption ionization-time of flight mass spectrometer to BD Phoenix automa- ted microbiology system for identification of gram-negative bacilli. J Clin Microbiol 2011;49:887-